- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $6,456.54 / $13,182.57
| Facility | | $776.25 | $6,456.54 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $5,011.87 / $10,964.78
| Professional | | $537.03 | $5,011.87 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $11,481.54 / $26,302.68
| Facility | | $5,128.61 | $11,481.54 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $6,760.83 / $17,378.01
| Professional | | $5,128.61 | $6,760.83 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,995.26 / $16,595.87
| Facility | | $724.44 | $1,995.26 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $8,912.51
| Professional | | $724.44 | $724.44 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $5,754.40 / $53,703.18
| Facility | | $34.67 | $5,754.40 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,511.89 / $15,135.61
| Professional | | $549.54 | $2,511.89 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $676.08 / $1,698.24
| Facility | | $512.86 | $676.08 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $9,332.54 / $12,302.69
| Professional | | $6,165.95 | $9,332.54 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,606.93 / $9,772.37
| Professional | | $3,630.78 | $6,606.93 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $14,454.40 / $23,442.29
| Facility | | $2,344.23 | $14,454.40 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $50,118.72 / $75,857.76
| Facility | | $602.56 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $8,511.38 / $9,549.93
| Professional | | $6,918.31 | $8,511.38 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $13,489.63 / $33,884.42
| Facility | | $2,818.38 | $13,489.63 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $5,623.41 / $13,803.84
| Professional | | $489.78 | $5,623.41 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $630.96 / $870.96
| Facility | | $407.38 | $630.96 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $5,248.07 / $8,912.51
| Professional | | $851.14 | $5,248.07 | $8,912.51 |